Medicine's Neglected Half

The relevance of palliative care is growing. In Covid times, it can provide total care

- Harmala Gupta

The relevance of palliative care is growing thanks to the rise in non-communicable diseases and chronic lifelong conditions.

The list of those who need palliative care is keeping pace with the increase in the average human life span. Earlier, it was primarily restricted to people with cancer. Now those with HIV/AIDS, neurodegenerative disorders (including forms of dementia), progressive neuromuscular diseases, metabolic disorders, terminal organ failures, cardiac or respiratory conditions, liver conditions, and others, are all included.

Palliative care today is therefore no longer just for terminal patients. There are people living with incurable health conditions, and palliative care can give them a good quality of life provided they use it early. Yet palliative care is not recognised as it should be, and access to it is restricted. This not only impacts a large population negatively but hurts the socially and economically disadvantaged the most.

According to the WHO, approximately 40 million people annually are in need of palliative care, of whom 78% live in low and middle income countries. Of the estimated 21 million children who have palliative care needs, almost 98% live in low and middle income countries. Add to this list a new fast emerging group of “long haulers”, those who will have to live with the long term side effects of SARS-CoV-2, and you have a veritable deluge of people who need effective symptom control and psychosocial and spiritual support, with little hope of getting it from existing health systems.